# WATERMARK BELLEVUE, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** The Springs at Pacific Regent
- **Organization subpart:** No

## Provider details

- **NPI number:** 1033597059
- **Authorized official:** GRETA FRAZIER (DIRECTOR)
- **Authorized official phone:** (520) 797-4000

## Contact information

- **Practice address:** 919 109TH AVE NE, BELLEVUE, WA 98004-4485
- **Practice address phone:** (425) 646-9808
- **Practice address fax:** (425) 453-8274
- **Mailing address:** 2020 W RUDASILL RD, ATTN: MEDICARE BILLING, TUCSON, AZ 85704-7800
- **Mailing address phone:** (520) 797-4000
- **Mailing address fax:** (520) 797-7757

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | — | NULL | Yes |

## Other

- **Enumeration date:** 05/11/2015
- **Last updated:** 07/15/2015

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 505371 | MEDICARE PTAN | — |